Project Summary/Abstract The goal of this application is to support Nikki Carroll, MS, as a Research Specialist and Biostatistician at Kaiser Permanente Colorado Institute for Health Research. She supports the Cancer and Genomics Research Core under the direction of Debra Ritzwoller, PhD. The core of Ms. Carroll?s productive and successful career as a Research Specialist and Biostatistician is in cancer related treatment patterns and outcomes. This Research Specialist award would allow 5 years of funding to maintain protected time for Ms. Carroll to work exclusively on supporting and leading cancer research aimed at generating real-world evidence on cancer care that occurs outside of clinical trials. In particular, she will study the treatment patterns and risk of recurrence among those with screen detected lung cancer compared to lung cancers diagnosed outside of screening. These results could impact prognostic estimates, treatment choices, and future trials to develop tailored treatment and surveillance regimens for early-stage, screen-detected lung cancer patients and set the foundation for future studies of the natural history of lung cancer screening in community settings. Results will be broadly disseminated through local and national meetings as well as peer-reviewed journal manuscripts.